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IRCT20250629066291N1 IRCT 2025-09-06 Shiraz University of Medical Sciences Comparison of suboccipital and diaphragm muscle release on posture, pain, and functional ability in patients with symptomatic forward head posture Comparison of suboccipital myofascial release and diaphragm myofascial release on posture, pain and functional ability in patients with symptomatic forward head posture: A randomized clinical trial study 2025-09-20 anticipated 48 Complete https://irct.ir/trial/85502 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: The random assignment method in this study will be the blocked permutation method (number of blocks 8 and block size 4) which will be generated using randomizer site. The samples will be assigned in a 1:1 ratio. Opaque, sealed envelopes will be used to conceal the assignment, Blinding description: The individual who performs the assessments is separate from the one who administers the treatments, and neither is aware of the other's work. The person responsible for randomization is also independent from both of the aforementioned individuals. 3 Forward head posture. Intervention 1: Intervention group1: Diaphragm release and therapeutic exercise. To perform diaphragm release, the patient sits upright, and the therapist, positioned behind them, wraps his/her hands around the patient's rib cage in such a way that their fingers are placed beneath the costal margin. To relax the rectus abdominis muscle, the patient bends their torso forward. During the patient's exhalation, the therapist grasps the lower ribs from the costal margin area and maintains this position for 5 to 7 minutes. Intervention 2: Intervention group2: Suboccipital release and therapeutic exercise. To perform suboccipital release, the patient is asked to lie on his/her back while the therapist sits on a chair at the level of the patient’s head. The therapist’s elbows are supported by the treatment table, and the forearms are positioned in supination. The patient is instructed to rest their head on the therapist’s palms. Then, the therapist places the pads of four fingers from both hands on either side of the second cervical vertebra, just below the occipital area, and maintains pressure until a sensation of melting is felt. The duration of the intervention is 4 minutes. Intervention 3: Control group: Therapeutic exercise. Yes - There is a plan to make this available What will be shared: Information collection form including primary and secondary outcomes, informed consent form and SPSS file When: After publication the results of the study To whom: Researchers working in academic and scientific institutions Conditions: Only for recording information in scientific databases Where to obtain: Correspondence with the project manager by email. Haghighat_fa@yahoo.com How to obtain: Maximum one month after sending the request by email Comments:
public Farzaneh Haghighat
Mehr Building, Shahid Chamran Hospital, Shahid Chamran Boulevard
Shiraz Iran (Islamic Republic of) 7194815644 +98 71 3624 0101 haghighat_fa@yahoo.com Shiraz University of Medical Sciences scientific Farzaneh Haghighat
Mehr Building, Shahid Chamran Hospital, Shahid Chamran Boulevard
Shiraz Iran (Islamic Republic of) 7194815644 +98 71 3624 0101 haghighat_fa@yahoo.com Shiraz University of Medical Sciences Iran (Islamic Republic of) Age range: 18 to 40 years Having reported neck pain for at least the past 6 weeks CVA angle must be less than 49.9 degrees Individuals must present tenderness in the diaphragm Average daily use of mobile phones and computers should be 4 hours or more, or 4 continuous hours of computer use in a seated position 18 years 40 years Both Visual and auditory impairments Neurological disorders Balance disorders History of surgery in the neck and spine area History of any trauma to the cervical spine, such as whiplash injury Cognitive impairments Inflammatory diseases such as rheumatoid arthritis History of any fracture in the neck area Congenital defects in the neck area (e.g., torticollis) Respiratory diseases and shingles Professional athletes Cervical spinal canal stenosis Radicular pain related to the neck area Malignancy Fibromyalgia Undergoing physiotherapy treatment in the past six months Use of painkillers, anti-inflammatory drugs, or muscle relaxants in the past 72 hours History of clavicle and rib fractures R29.3 Abnormal posture Treatment - Other Treatment - Other Treatment - Other Intervention group1: Diaphragm release and therapeutic exercise. To perform diaphragm release, the patient sits upright, and the therapist, positioned behind them, wraps his/her hands around the patient's rib cage in such a way that their fingers are placed beneath the costal margin. To relax the rectus abdominis muscle, the patient bends their torso forward. During the patient's exhalation, the therapist grasps the lower ribs from the costal margin area and maintains this position for 5 to 7 minutes. Intervention group2: Suboccipital release and therapeutic exercise. To perform suboccipital release, the patient is asked to lie on his/her back while the therapist sits on a chair at the level of the patient’s head. The therapist’s elbows are supported by the treatment table, and the forearms are positioned in supination. The patient is instructed to rest their head on the therapist’s palms. Then, the therapist places the pads of four fingers from both hands on either side of the second cervical vertebra, just below the occipital area, and maintains pressure until a sensation of melting is felt. The duration of the intervention is 4 minutes. Control group: Therapeutic exercise Head postural status. Timepoint: Before intervention; One day after intervention period. Method of measurement: Craniovertebral angle. Pain intensity. Timepoint: Before intervention; One day after intervention period. Method of measurement: Numerical pain rating scale. Functional ability. Timepoint: Before intervention; One day after intervention period. Method of measurement: Neck disability index. Shiraz University of Medical Sciences Approved 2025-05-07 Ethics committee of Shiraz University of Medical Sciences Ethics committee, Research and Technology Vice-Chancellor, 7th floor, Central building of Shiraz University of Medical Sciences, Zand Street Shiraz Fars Iran (Islamic Republic of)